It’s just a little leakage when you go for a run. A pantyliner will do the trick. Just don’t forget to cross your legs before you sneeze or laugh. Oh and sex hurts, but let’s face it, you’re too tired to be intimate with you partner anyway. You have a toddler now. It’s not ideal, but this is what you signed up for when you had babies. This is normal. You don’t need pelvic floor PT.
…Right?
Common? Yes. Normal? NO! “You deserve to live the rest of your life without leakage or discomfort” says Doctor or Physical Therapy Lynne DiPirro. Dr. DiPirro is a postpartum corrective exercise specialist based out of Mattapoisett, MA. She shared some tips with me on how to get the most out of your pelvic physical therapy visits and get you back to feeling like yourself.
Be Your Best Historian
“Your PT will take you through a fairly extensive history intake, including questions about your bladder, bowel, sexual history and pain history. This gives us A LOT of information about what might be going on,” says Dr. DiPirro. Therefore, before your appointment it’s a good idea to take some notes about your symptoms. Your therapist may look at factors such as time of day, fluid intake, type of fluid and symptom quality (i.e. burning, urgency, dull ache etc). If your symptoms are activity-related, write down how far into your activity you notice symptoms or certain positions/postures that exacerbate your pain. You may even want to take note of what clothing you are wearing. Something as simple as tight jeans versus loose joggers may give a clue on how to best treat you.
Find a Good Fit
While some of us are more comfortable than others, getting professional help for our pelvic floor is a very vulnerable situation. Make sure you feel comfortable and vibe with your therapist. “The most important thing is that you need to feel HEARD and SEEN. We are here to empower YOU!!” says Dr. DiPirro. It’s also important to feel confident in and trust your therapist. Feel free to ask them about their experience. How long have they been treating clients with pelvic floor issues? How much experience do they have with your specific concern? Have they done any additional certifications or passed any board exams specific to pelvic physical therapy? Do they like Taylor Swift? (Okay maybe not, but hey I did say you want to vibe with your therapist!) Knowing the answers to these questions can also help you feel comfortable and trust that you are in kind and capable hands.
Yes, You May Benefit From An Internal Exam
I know. You hoped you were done with internal exams after you gave birth. However, depending on your suspected diagnosis and personal circumstances, your PT might recommend an internal exam to assess the muscles supporting your pelvic floor. “This exam is NOT required, but it is extremely helpful for the PT. If you are uncomfortable with this, let your PT know so they can perform additional external tests,” explains Dr. DiPirro.
Be Open with Your PT
We’ve all gotten our hair cut, absolutely hated it, didn’t say anything to our stylist and just cried alone in our car (just me? Cool cool). Don’t let that be your experience with your pelvic floor health! In all seriousness, your therapist has heard it all and is ready to support you no matter what. Are you skeptical that PT doesn’t actually work? Haven’t done a single home exercise since you started? Are you really anxious about internal work? Definitely tell your therapist! Open communication is the best way to make sure you’re a team together and on the same page.
You DO Have To Do The Exercises
When it comes to muscles, slow and steady always wins the race. Research shows that it takes up to 4 weeks for muscles to even begin to show measurable improvement. It can then take even longer (think up to 12 weeks) of consistent strengthening/retraining to see enough strength improvements that you functionally notice a difference. Try scheduling a time every day where you can devote a few minutes to knocking out your home program. If you find the program unmanageable, talk to your PT about prioritizing the activities that are most important to do. Also, if you’re feeling discouraged about your progress, bring this up to your therapist! They can either tweak the home program or remind you of the progress you’ve made.
Dr. Lynne DiPirro is a Doctor of Physical Therapy and a Postpartum Corrective Exercise Specialist. She has an office in Mattapoisett, MA as well as online pelvic health coaching for those who can’t make it into the office. You can learn more about her practice here.
As always, this is not meant to be a substitute of professional medical advice. Seek the counsel of your health care provider for additional information.
Also— you’re doing great. Keep it up.
